Prostatitis and Its Management: Concepts and Recommendations for Clinical Practice

150 Pages·2016·4.53 MB·English

by  Tommaso Cai

Tommaso Cai
Truls E. Bjerklund Johansen Editors
Prostatitis and
Its Management
Concepts and Recommendations
for Clinical Practice
123
Prostatitis and Its Management

Tommaso Cai (cid:129) Truls E. Bjerklund Johansen
Editors
Prostatitis and Its
Management
Concepts and Recommendations
for Clinical Practice
Editors
Tommaso Cai Truls E. Bjerklund Johansen
Department of Urology Department of Urology
Santa Chiara Regional Hospital Oslo University Hospital
Trento Oslo
Italy Norway
ISBN 978-3-319-25173-8 ISBN 978-3-319-25175-2 (eBook)
DOI 10.1007/978-3-319-25175-2
Library of Congress Control Number: 2015957687
Springer Cham Heidelberg New York Dordrecht London
© Springer International Publishing Switzerland 2016
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Foreword
A fter many years of daily involvement in clinical management of urologic patients,
I can surely say that prostatitis is one of the biggest clinical challenges within our
discipline. The two main characteristics of the disease are its high frequency while –
at the same time – limited knowledge is available to the practitioner about the dis-
ease and, secondly, its low prognostic severity yet strong impact on their patients’
quality of life. This is due to the fact that this urological topic still remains poorly
understood, inadequately treated and under-researched. Surely much has changed
over the last decades. The initial classifi cation system that was based upon the
“4-glass test” has been replaced by a more recent classifi cation system introduced
by the National Institute of Health (NIH) focusing on clinical symptoms rather than
aetiology which still remains largely unknown. For a long time a validated symptom
score was not available, and well-conducted clinical trials were completely lacking.
Outcome research has improved our understanding of the incidence, quality of life
and economic impact of the disease. Finally, we now have a validated symptom
score that appears to adequately measure both symptom severity and response to
therapy, and numerous randomized placebo-controlled trials using symptoms as an
outcome parameter have been conducted over time which has increased our knowl-
edge on how to improve our management of prostatitis patients. The purpose of this
book is to review the state of the art in prostatitis combining practical clinical rec-
ommendations with cutting-edge clinical research, basic science and questions for
the future. The authors are very well-known experts in the fi eld and have surely
based their personal contribution on the most updated scientifi c evidence without
forgetting to share the tricks derived from their precious and vast clinical expertise.
Chapters cover the epidemiology and classifi cation of the disease, the diagnostic
approach – including imaging studies – and the therapeutic approach to different
subtypes of prostatitis. Special focus is reserved for the role of phytotherapy, the
management of infective complications following prostate biopsy, the contribution
of prostate infection and infl ammation to BPH and cancer, the role of STD
v
vi Foreword
pathogens in bacterial prostatitis patients and the implications of prostatitis on sex-
ual and reproductive function. It is my sincere hope that the readers will fi nd within
this text practical, yet novel, approaches to assist their patients in their clinical prac-
tice and come to rely on and refer to it often as a handy reference which enables
them to fully recognize, comprehend, diagnose and treat this all-too-common
prostate- related pathology.
Vincenzo Mirone
Department of Urology
University of Naples
Naples, Italy
Contents
1 Introduction and Aim of the Book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Tommaso Cai and Truls E. Bjerklund Johansen
2 Epidemiology and Microbiological Considerations:
What’s New? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Sandra Mazzoli , Tommaso Cai , Marco Puglisi ,
and Riccardo Bartoletti
3 The Diagnostic Approach to Patients with Prostatitis-Like
Symptoms: What Do We Have to Do? . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Andrea Benelli and Florian M. E. Wagenlehner
4 Classification of Prostatitis: What Is the Clinical Usefulness? . . . . . . . 17
Riccardo Bartoletti and Tommaso Cai
5 Imaging Studies: What Is Their Role? . . . . . . . . . . . . . . . . . . . . . . . . . . 27
N. Pavan , S. Rai , F. Vedovo , M. Bertolotto , M. Iannelli ,
C. Trombetta , and G. Liguori
6 Treatment of Bacterial Prostatitis: Clinico-Pharmacological
Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Gianpaolo Perletti and Vittorio Magri
7 Treatment of Nonbacterial Prostatitis: What’s New? . . . . . . . . . . . . . . 49
Paolo Verze and Luca Venturino
8 The Role of Phytotherapy in the Management
of Prostatitis Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Zafer Tandogdu and Mete Cek
9 Management of Infective Complications
Following Prostate Biopsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Truls E. Bjerklund Johansen , Catherine E. P. Pereira ,
and Vladimir Mouraviev
10 The Contribution of Prostate Infection and Inflammation to BPH
and Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Francesca Pisano
vii
viii Contents
11 The Role of STD Pathogens in Bacterial Prostatitis . . . . . . . . . . . . . . . 95
Tommaso Cai and Daniele Tiscione
12 Andrologic Sequelae in Prostatitis Patients . . . . . . . . . . . . . . . . . . . . . 109
Jamil Syed and Vladimir Mouraviev
13 The Role of Chronic Prostatitis in Male Infertility: Is There
a Relationship? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Vitaly Smelov
14 Elevated PSA as Differential Diagnostic Error-Source
in Prostate Cancer with Consequences in Medical Law . . . . . . . . . . . 131
Karl-Horst Bichler and Kurt G. Naber
15 The Prostatitis Patient: “A Clinical Dialogue” . . . . . . . . . . . . . . . . . . . 141
Tommaso Cai and Truls E. Bjerklund Johansen
1
Introduction and Aim of the Book
Tommaso Cai and Truls E. Bjerklund Johansen
Prostatitis is one of the most common illnesses in young men with different clinical
presentation such as pelvic pain, lower urinary tract symptoms, or sexual dysfunc-
tion and a high impact on their quality of life. The management of prostatitis patients
is still today a challenge for the urologist, andrologist, and the general practitioner.
The recent acquisitions in terms of epidemiological data and the latest classifi cation
from the National Institutes of Health (NIH) have triggered a better management of
the prostatitis patient. However, there are holes in our knowledge about the patho-
physiology, pathogenesis, and causative pathogens which can make it diffi cult to
fi nd the best treatment for our patients. The need for an improved knowledge is
demonstrated by the high number of patients who drop out from scheduled treat-
ments and are lost to follow-up. At the same time, we see a high number of new
drugs and phythotherapeutic compounds being introduced in the pharmacopeia and
on the market. The situation calls for a standardization of the management of pros-
tatitis patients. On this background, the idea was born to bring together experts in
the fi eld to give an update on current knowledge and share practical advices on the
management of prostatitis patients. This book aims to provide a comprehensive
description of prostatitis, from diagnosis till therapy. This book will be the fi rst
handbook addressing all clinical aspects of the prostatitis syndrome and providing
the reader with all necessary information to design a tailored therapy. Furthermore,
the editors aim to analyze and discuss all relevant clinical implications of the dis-
ease, in particular andrological complications (infertility), the possible link between
prostatitis and prostate cancer, and infectious complications of prostate biopsies.
T. Cai (*)
Department of Urology , Santa Chiara Regional Hospital , Trento , Italy
e-mail: [email protected]
T. E . Bjerklund Johansen
Department of Urology , Oslo University Hospital , Oslo , Norway
Insitute of Clinical Medicine , University of Aarhus , Aarhus , Denmark
e-mail: [email protected]
© Springer International Publishing Switzerland 2016 1
T. Cai, T.E. Bjerklund Johansen (eds.), Prostatitis and Its Management: Concepts
and Recommendations for Clinical Practice, DOI 10.1007/978-3-319-25175-2_1